Wondering about Troponin Levels

[slynne7]

First, let me say that I have a hx of GERD and SVT. I have GERD to the point where it feels like a heart attack and spreads to my left arm and back. I have gone to the ER with the pain before, multiple times, and told that I was not having a heart attack, that I could be having esophageal spasms,  however, my SVT does show up on EKG and at some points shows A-fib. On Tuesday of last week, I started having my horrible chest pain, spreading to arms and back as usual. I was miserable until Friday when I started experiencing increase in heart rate, nausea and feeling dizzy,. It started about 9 AM. I left work and went to the ER at 6 PM. In the ER, medicine was given to slow SVT in IV and upon discharge the RN went over my lab work with my and my Troponin was <0.05. Seeing that number concerned me and the RN said I was fine. That if it was abnormal, I would not be leaving and even showed me that the lab did not flag it as being abnormal and/or High. He proceeded to tell me that 0.05-0.08 is considered "indeterminate" according to their lab. I ended back up in the ER again on Monday again with my SVT that was all over the place. Told ER Doc about Friday and he stated that there was no need for Cardiac workup even though I told him that I had chest discomfort and still had the tingling. I was given more medicine in my IV and sent home once HR returned to normal. I called about my results yesterday and the RN that answered told me that my results of 0.05 are completely negative and that anything higher, I would be admitted. I am still not feeling just right and wondered if I should be concerned about my level?

[2210485]

Absolutely the svt can elevate it. Of course if your blood flow is restricted in some way you might also see loss in your hearts ability to compensate for the myocardial demand, compounding the matter. This can, in theory lead to chest pain. Dyspnea and st segment depressions following the tachycardia episode.

The reason I said i'd stress it isn't due to a concern for a positive likely outcome per se, but because theres really nothing to be lost from testing it just to see what happends. The indications for doing so are so broad that a slightly elevated troponin is ample justification.

Really the worst case scenario is you go into svt on the treadmill making a conclusive result impossible.

Id ask your cardiologist for an opinion on the matter, as each individual case varies, as do practice standards.

[2210485]

They didn't give you a cardiology referral? Just broke your svt and gave you the boot without any more info ?  Doesn't seem right, bring all the documentation to your primary doctor. He should able to determine the need for a refferal or lack thereof.

As for your levels they are supposed to be 0.00, so they're not super high, but theyre not normal either, i would at least watch it to see where they go.

Especially if you're getting elevated trops during your svt. Might be worth stress testing.

In my opinion stress and holters should be given out like candy. Theyre valuable diagnostic tools that are safe and non invasive.

[slynne7]

I have an appointment with a Cardiologist/Electrophysiologist on Monday. I went to get my medical records on Wednesday and talked with another ER Doctor who stated that my EKG's all were normal and that my Tropinin was normal as well. She said she would never be concerned about that level and that my SVT, palpitations and arrhythmias could cause a slightly higher level than 0.0 but that even <0.05 is negative and undetectable.